Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis

Stephen Rottgers, Hasan R. Syed, Diana S. Jodeh, Yasser Jeelani, Edward Yang, John G. Meara, Mark R. Proctor

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Endoscopic suturectomy and helmeting represents a successful first-line surgical treatment for bilateral coronal craniosynostosis. Its effect on cranial morphology has not been previously described. METHODS: Patients were identified who had bilateral coronal craniosynostosis treated with endoscopic suturectomy and postoperative helmeting at Boston Children's Hospital between 2005 and 2013 and who underwent preoperative and postoperative computed tomography. Two normative patient populations were identified from our trauma registry with computed tomographic scans completed at the same age as our pretreatment and posttreatment scans. Craniometric indices were used to quantify the effect of treatment. RESULTS: Twenty-seven patients were identified who underwent bilateral coronal suturectomy. Twelve patients had preoperative and postoperative computed tomographic studies. Eight patients (66.7 percent) were syndromic. The average ages for preoperative and postoperative computed tomographic scan were 1.1 months (range, 0.03 to 2.6 months) and 19.6 months (range, 10.8 to 37.5 months). Thirteen patients with an average age of 1.1 months (range, 0.5 to 1.6 months) were identified as a preoperative control group. Fourteen patients with an average age of 18.5 months (range, 15.5 to 22.9 months) were identified as a postoperative control group. The anterior cranial height stabilized with treatment and the anterior cranial base length increased. The anterior cranial height-to-anterior cranial base length ratio significantly decreased with treatment (p = 0.128). Frontal bossing normalized with endoscopic suturectomy (craniosynostosis versus control: preoperatively, p = 0.001; postoperatively, p = 0.8). Cephalic indices also normalized with treatment (craniosynostosis versus control: preoperatively, p = 0.02; postoperatively, p = 0.13). No cases of hydrocephalus were observed. CONCLUSION: Endoscopic suturectomy and helmeting improves anterior turricephaly and corrects frontal bossing and brachycephaly in patients with bilateral coronal craniosynostosis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Original languageEnglish (US)
Pages (from-to)183-196
Number of pages14
JournalPlastic and Reconstructive Surgery
Volume143
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Craniosynostoses
Skull Base
Therapeutics
Control Groups
Base Composition
Hydrocephalus
Registries
Head
Tomography
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis. / Rottgers, Stephen; Syed, Hasan R.; Jodeh, Diana S.; Jeelani, Yasser; Yang, Edward; Meara, John G.; Proctor, Mark R.

In: Plastic and Reconstructive Surgery, Vol. 143, No. 1, 01.01.2019, p. 183-196.

Research output: Contribution to journalArticle

Rottgers, Stephen ; Syed, Hasan R. ; Jodeh, Diana S. ; Jeelani, Yasser ; Yang, Edward ; Meara, John G. ; Proctor, Mark R. / Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis. In: Plastic and Reconstructive Surgery. 2019 ; Vol. 143, No. 1. pp. 183-196.
@article{1a0554a383ac4395827ab1fc060fd092,
title = "Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis",
abstract = "BACKGROUND: Endoscopic suturectomy and helmeting represents a successful first-line surgical treatment for bilateral coronal craniosynostosis. Its effect on cranial morphology has not been previously described. METHODS: Patients were identified who had bilateral coronal craniosynostosis treated with endoscopic suturectomy and postoperative helmeting at Boston Children's Hospital between 2005 and 2013 and who underwent preoperative and postoperative computed tomography. Two normative patient populations were identified from our trauma registry with computed tomographic scans completed at the same age as our pretreatment and posttreatment scans. Craniometric indices were used to quantify the effect of treatment. RESULTS: Twenty-seven patients were identified who underwent bilateral coronal suturectomy. Twelve patients had preoperative and postoperative computed tomographic studies. Eight patients (66.7 percent) were syndromic. The average ages for preoperative and postoperative computed tomographic scan were 1.1 months (range, 0.03 to 2.6 months) and 19.6 months (range, 10.8 to 37.5 months). Thirteen patients with an average age of 1.1 months (range, 0.5 to 1.6 months) were identified as a preoperative control group. Fourteen patients with an average age of 18.5 months (range, 15.5 to 22.9 months) were identified as a postoperative control group. The anterior cranial height stabilized with treatment and the anterior cranial base length increased. The anterior cranial height-to-anterior cranial base length ratio significantly decreased with treatment (p = 0.128). Frontal bossing normalized with endoscopic suturectomy (craniosynostosis versus control: preoperatively, p = 0.001; postoperatively, p = 0.8). Cephalic indices also normalized with treatment (craniosynostosis versus control: preoperatively, p = 0.02; postoperatively, p = 0.13). No cases of hydrocephalus were observed. CONCLUSION: Endoscopic suturectomy and helmeting improves anterior turricephaly and corrects frontal bossing and brachycephaly in patients with bilateral coronal craniosynostosis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.",
author = "Stephen Rottgers and Syed, {Hasan R.} and Jodeh, {Diana S.} and Yasser Jeelani and Edward Yang and Meara, {John G.} and Proctor, {Mark R.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/PRS.0000000000005118",
language = "English (US)",
volume = "143",
pages = "183--196",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis

AU - Rottgers, Stephen

AU - Syed, Hasan R.

AU - Jodeh, Diana S.

AU - Jeelani, Yasser

AU - Yang, Edward

AU - Meara, John G.

AU - Proctor, Mark R.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BACKGROUND: Endoscopic suturectomy and helmeting represents a successful first-line surgical treatment for bilateral coronal craniosynostosis. Its effect on cranial morphology has not been previously described. METHODS: Patients were identified who had bilateral coronal craniosynostosis treated with endoscopic suturectomy and postoperative helmeting at Boston Children's Hospital between 2005 and 2013 and who underwent preoperative and postoperative computed tomography. Two normative patient populations were identified from our trauma registry with computed tomographic scans completed at the same age as our pretreatment and posttreatment scans. Craniometric indices were used to quantify the effect of treatment. RESULTS: Twenty-seven patients were identified who underwent bilateral coronal suturectomy. Twelve patients had preoperative and postoperative computed tomographic studies. Eight patients (66.7 percent) were syndromic. The average ages for preoperative and postoperative computed tomographic scan were 1.1 months (range, 0.03 to 2.6 months) and 19.6 months (range, 10.8 to 37.5 months). Thirteen patients with an average age of 1.1 months (range, 0.5 to 1.6 months) were identified as a preoperative control group. Fourteen patients with an average age of 18.5 months (range, 15.5 to 22.9 months) were identified as a postoperative control group. The anterior cranial height stabilized with treatment and the anterior cranial base length increased. The anterior cranial height-to-anterior cranial base length ratio significantly decreased with treatment (p = 0.128). Frontal bossing normalized with endoscopic suturectomy (craniosynostosis versus control: preoperatively, p = 0.001; postoperatively, p = 0.8). Cephalic indices also normalized with treatment (craniosynostosis versus control: preoperatively, p = 0.02; postoperatively, p = 0.13). No cases of hydrocephalus were observed. CONCLUSION: Endoscopic suturectomy and helmeting improves anterior turricephaly and corrects frontal bossing and brachycephaly in patients with bilateral coronal craniosynostosis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

AB - BACKGROUND: Endoscopic suturectomy and helmeting represents a successful first-line surgical treatment for bilateral coronal craniosynostosis. Its effect on cranial morphology has not been previously described. METHODS: Patients were identified who had bilateral coronal craniosynostosis treated with endoscopic suturectomy and postoperative helmeting at Boston Children's Hospital between 2005 and 2013 and who underwent preoperative and postoperative computed tomography. Two normative patient populations were identified from our trauma registry with computed tomographic scans completed at the same age as our pretreatment and posttreatment scans. Craniometric indices were used to quantify the effect of treatment. RESULTS: Twenty-seven patients were identified who underwent bilateral coronal suturectomy. Twelve patients had preoperative and postoperative computed tomographic studies. Eight patients (66.7 percent) were syndromic. The average ages for preoperative and postoperative computed tomographic scan were 1.1 months (range, 0.03 to 2.6 months) and 19.6 months (range, 10.8 to 37.5 months). Thirteen patients with an average age of 1.1 months (range, 0.5 to 1.6 months) were identified as a preoperative control group. Fourteen patients with an average age of 18.5 months (range, 15.5 to 22.9 months) were identified as a postoperative control group. The anterior cranial height stabilized with treatment and the anterior cranial base length increased. The anterior cranial height-to-anterior cranial base length ratio significantly decreased with treatment (p = 0.128). Frontal bossing normalized with endoscopic suturectomy (craniosynostosis versus control: preoperatively, p = 0.001; postoperatively, p = 0.8). Cephalic indices also normalized with treatment (craniosynostosis versus control: preoperatively, p = 0.02; postoperatively, p = 0.13). No cases of hydrocephalus were observed. CONCLUSION: Endoscopic suturectomy and helmeting improves anterior turricephaly and corrects frontal bossing and brachycephaly in patients with bilateral coronal craniosynostosis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

UR - http://www.scopus.com/inward/record.url?scp=85059229594&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059229594&partnerID=8YFLogxK

U2 - 10.1097/PRS.0000000000005118

DO - 10.1097/PRS.0000000000005118

M3 - Article

C2 - 30325899

AN - SCOPUS:85059229594

VL - 143

SP - 183

EP - 196

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 1

ER -